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Considerations for prophylactic surgery in asymptomatic severe cervical stenosis: review article
Abdel Majid Sheikh Taha1, Jennifer Shue2, Darren Lebl1
1Department of Orthopedic Surgery, Spine and Scoliosis Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA ; Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065 USA.
Summary
Evidence is lacking for or against surgery in asymptomatic cervical spondylotic myelopathy (CSM) with severe stenosis. Management plans should consider patient factors and involve shared decision-making.
Area of Science:
- Neurosurgery
- Spinal Surgery
Background:
- Cervical spondylotic myelopathy (CSM) significantly impairs quality of life.
- Symptoms often become irreversible before manifestation.
- Surgical intervention is standard for symptomatic CSM.
Purpose of the Study:
- To evaluate the necessity of intervention for asymptomatic CSM with radiographic stenosis.
- To address the decision-making process for such cases.
Main Methods:
- Literature review of PubMed publications on asymptomatic CSM.
- Screening of abstracts and relevant article references.
Main Results:
- 14 papers were reviewed, with 7 deemed relevant.
- 3 articles directly addressed the study's topic.
Conclusions:
- Limited evidence exists regarding surgery for asymptomatic CSM with severe stenosis.
- Management should incorporate patient age, activity level, and injury risk.
- Shared decision-making with the patient is crucial.
